tv Key Capitol Hill Hearings CSPAN June 13, 2015 3:00am-5:01am EDT
nding litigation. little bit of a cute response in my view, but it's your play. now, where there is no litigation pending and the issue is exactly the same is on the issue of basic health programs. so it wouldn't be satisfactory to say, you got to check with justice, because they're not involved in any litigation because there is no litigation between us at this point in time. so here's my question. the law's really clear that you can't spend money that hasn't been appropriated. there's no ambiguity about that. the constitution's clear, the gao states this, many, many different entities say that money cannot be spent absent an appropriation. and yet there are a number of states that are announcing that, you know, minnesota was a state that says they're going to be implementing the program, new york has announced that they'll operate the basic health program starting in january of 2016. new york has estimated that they'll receive $2.5 billion, "b," billion. how is this possible since the
money has never been appropriated? in other words, what extra constitutional authority are you invoking that allows you to spend money that's not been appropriated? >> with regard to the issue of 1311 and where that is, i think 131 1 is about states that want to choose and try to do what thins and ways that seek flexibility. and that's what we do is try to work with states when they do that. with regard to the authority both for the cost sharing issue in 1311, in the budget appendix, it's the place where we believe the authorities lie. >> but there's been no appropriation. you'll acknowledge that, won't you? >> with regard to the authorities there, what we believe is the authorities for the aptc are the authorities because that is what the money -- >> but you're conflating two concepts.
you're conflating authorization, which i'm not arguing with, and appropriation. there's been authorization, but there's been no appropriation. how do you appropriate money that hasn't been appropriated? >> but for programs that are tax credits for programs, those aren't part of our discretionary budget every year. in terms of discretionary programs, the earned income tax credit, other tax programs and tax credits are not a part of the discretionary process. >> so just to follow up, would you be willing to come in and give a briefing to me and also to chairman tim murphy who chairs the oversight subcommittee at energy and commerce to clear up these things when we have more time together. >> congressman, we'd look forward to the opportunity to try to clear this up and have the right people come and discuss these issues. >> thanks very much. one other quick point. you mentioned in your opening statement that there was $22 billion in fraud savings, which is okay, not great. the problem is -- and mr. lewis and i found this out together along with all the members of our subcommittee, by medicare's own admission, medicare is wasting a billion dollars a
week. every single week in fraudulent and erroneous payments. so $22 billion over the decade is okay, but it's like turning it off halfway through the year and then letting 9 1/2 years go and do nothing. so i think really need to up the game. i yield back. >> thank you. mr. thompson. >> thank you, mr. chairman. thank you for having the hearing and helping to subsidize my california constituents and their health care. appreciate that. madam secretary, thank you for coming out. i hear a lot from my constituents as well about the aca. i hear from people who are pleased that the pre-existing conditions is no longer an issue for them. that their 26-year-old can stay on their policy. that they have access to quality preventive care, which i know for a fact will save us all money in the long run.
but i also hear them say that they recognize their problems with the aca, and they want us to work together to fix those problems. so i don't know how it could be a lot different than other parts of the country. my experience has been that folks want access to quality, affordable health care. and we do have a responsibility to figure out how to make that happen, and i appreciate your effort in that regard. so i'm all for fixing, making tweaks, making adjustments. congress member black and i are going to introduce legislation today, as a matter of fact, that falls into that category of making a tweak, making a fix. we're going to introduce a bill that would ease the reporting requirements for employers offering coverage to their employees, and it would require that the exchanges use the most recent tax data to insure that individuals and families will not have a large tax bill at the end of the year.
as i'm sure you know, covered california, in my home state of california, requires that the most recent tax data be used, and it's worked well and it's been beneficial. i'm just wondering if you have any thoughts on requiring the more recent tax data to determine eligibility for subsidies especially for auto renewals and making that apply to all the exchanges? >> i think it is in our interest, and what we want to seek to do is get the most up to date information we can possibly have which is why we encourage people to come in and update throughout the year. we continue to do that. with regard to the specifics of this piece, i think we'd have to look at the legislation. i'm not sure if it sits with treasury or with us, but we would work together to understand. because i think what we want is actually to have the most up to
date information, and that information for some people is an evolving and changing piece of information for those who are self-employed, their incomes change throughout the year and we do have means by which they can come in and update it. we try and encourage them to do that. so the most up to date information that we can implement is something that we do support. and so with regard to the specifics of the legislation, we'd like to have the opportunity to look at it and understand between us and treasury where we could be. >> thank you. i also had some questions regarding the racks and the appeals process. i understand from your staff that we're going to work together outside of that committee hearing to deal with that. so i appreciate that commitment. i assume it's shared by you. >> yes, it is. i would also use this just as an opportunity to again mention the piece of legislation bipartisan that senate finance just passed this past week on this issue in terms of the strategic approach to help us get to a place to reduce that backlog of appeals. there's administrative things we can do but we do need statutory help. senators widen and hatch have led on that, we hope we can work with you, too. >> mr. boustany had questions about the hras. we're working on that legislation.
we hope that we can have the help of your agency in making sure this is the best legislation possible. >> thank you. >> we'll work with you. >> thank you. >> i yield back. >> dr. price recognized. >> madam secretary, with respect many of us here and across the land sincerely believe the principles that you hold dear, accessibility, affordability and quality are being harmed. i want to highlight the problems in the system that we believe are harming patients and in many cases destroying the ability of those working as hard as they can to care for those patients. one of them is the electronic health record and meaningful use. cms is dictating to physicians what must be documented and how and necessary for taking care of patients. it's wasting money, wasting time, wasting resources and, sadly, wasting the expertise of physicians. leading to further disgust on the part of physicians, many leaving practice. in fact, i know two individuals who said this was the last straw. and they quit. at an age where they could be
able to practice for years and years. there are positive solutions if we allow for flexibility and respect to those providing the care. icd-10, another example of cms making it more difficult for physicians to care for patients. in some cases in small rural practices, it would drive physicians out of business. so access is destroyed for those patients in those areas. the u.s. inappropriately combines and confuses clinical data. that's what's happening medically with a patient, with billing data. under the guise of wanting more information and saying that everybody else in the world is doing it. well the fact is that the u.s. will be the only country to use all 87,000 codes, the only country to use it in an outpatient setting, the only country to use it in a billing process and the only country to put the costs on the shoulders
of the physicians and those providing the care. this happens on october 1. it passed as prologue, sadly it holds real potential to being a significant disaster further harming docs and patients. i urge, i urge cms to delay any penalty for coding errors for at least two years. it's only reasonable given the magnitude of the change coming. durable medical equipment, oftentimes the only thing that stands between a patient's quality of life and hospitalization and even death in the instance of provisional oxygen is dme and a caring provider. if cms puts into place what they call competitive bidding, it doesn't work. harming patients and driving folks who have been wonderfully providing care in vftss and communities across this nation out of business further harming those patients. i urge, i plead with cms to allow at least allow a pilot demonstration to show that there's a much better way to save money and also provide services to patients. sadly, madam secretary, the
president continues to shamelessly condemn and attack those standing up for health care. as recently as yesterday he ignored reality and cynically mocked those striving for positive solutions. we know he's got a pen and a phone, what he doesn't seem to have is the knowledge or the humility or the concern or the desire to work together on behalf of those struggling to provide care and those receiving the care. madam secretary, i urge you, i urge you and your team to join with us in an open-minded way to end the oppression of meaningful use, to provide for flexibility so that more practices aren't destroyed, to allow for a pilot program to demonstration competitive bidding is hurting patients and that there's a much better way and to give physicians the freedom to care for patients. if you are sincere in your desire for accessibility and
affordability and quality, that would lead to your action working with us. and i look forward to that and hope that we'll be able to move in a positive direction. mr. chairman, i yield back. >> thank you. >> mr. larson. >> thank you, mr. chairman. thank you, madam secretary, thank you for your service. hailing from the great state of connecticut, we are so proud of the advances of the affordable care act and it's great to have a governor that's hands-on in terms of its implementation and all the progress that we know that has been made and will continue to be made under this act. mr. chairman, i would like to submit for the record a 28-page report entitled "the language of health care 2009" by frank lutz. is there objection? mr. chairman? >> no objection. >> i think i have a great deal of respect for mr. luntz, and he and stan greenberg, also another polster and someone who spends an awful lot of time on the science of language and looking
at in detail what people should say around subject matter areas. now, this is particularly of interest to me because it passed -- you know, this was recommended in 2009. and basically mr. luntz describes the ten rules for stopping the washington takeover of health care, and it's informative even to this debate today. for example, one of the things he says, the arguments against the democratic health care plan must center around politicians and bureaucrats in washington, not free markets, tax incentives or more competition.
so we'll hear a lot of that. it also goes on to underscore you simply must be vocal and passionate on the side of the reform. the status quo is no longer acceptable. if the dynamic becomes president obama is on the side of reform and republicans are against it, then the battle is lost and every word of this 30-page document is useless. he goes on to say this, and this is the whole point. it's not enough just to say what you're against. you have to tell them what you're for. it's okay and even necessary for your campaign to center around why this health care plan is bad for america, but if you offer no vision for what's better for america, then you'll be relegated to insignificance at best and labeled obstructionist at worst. what americans are looking for
in health care is what your solution is, what it will provide, the words of more access, more treatments and more doctors are sure winners. i agree with mr. luntz there, and that's what this subject should be about, for us providing more access. madam secretary, may i ask you, are you aware of any republican legislative proposals that reduce the number of uninsured in this country by more than 16 million and make sure that we continue to provide all the benefits of addressing pre-existing conditions, keeping your children on the plan and making sure we focus on prevention? >> i've not seen a proposal that does that. >> i thank you, madam secretary. with that, submitting this full report for the record, i think it's worth everybody's reading, and we ought to get back to what this committee should be doing and that's to put americans first and put americans on the road to having the best access, more access, more accessibility
and more availability to health care. thank you. >> thank you, and time for the gentleman has expired. we are going on to enter into the two to one phase, two on our side and one on the "d" side to keep it equal. mr. buchanan. >> thank you, mr. chairman and madam secretary. i appreciate you taking the time this week to give me a call and giving me the chance to visit. my biggest concern, you made four points, and at the top of the list -- i was chairman of the florida chamber. we had 147,000 businesses we represented. most of them were 50 employees or less. so a lot of small businesses. but the biggest issue, and it's before the aca goes back 15 years, is affordability.
and there was an expectation or a hope that we could bend the curb on affordability. there's no question people will get the subsidies, and they benefit. there's over a million in florida. but there's many just above that line, poverty line that don't get the subsidies. i want to talk on two bases. first, small business, their cost of trying to provide health care has gone up 20% to 30% the last three or four years. i just talked to another person the other day, 130 employees, it went up 30%. but throughout florida, throughout our region, we're not seeing any reduction or anything in terms of affordability from that standpoint. many times, last week we had a town hall, we had one woman -- or a couple weeks ago. we had one woman that says it's $2,000 a month to get health care. she can get it for less but then she has to pay some kind of a $10,000 in terms of her health
care if she has a claim. but what's your thought on the affordability where we're at as relates to people in terms of subsidies, that don't get subsidies? >> when we think about the affordability, we think some progress has been made. and we were seeing raising deductibles and growth and a slow in the program. the things we have seen slow down is the premium growth across a couple categories. we've also seen that medicare savings that i mentioned earlier, the over 300 billion terms of where we are in our medicare pricing, the other thing that's indicative is we've seen the per capita health care gross cost because we've seen so many people coming into medicare, the cost will go up because we have more elderly. we do focus on that -- >> let me just -- we are short on time. we are not seeing the discounts, per se. i would love to have you come to florida and talk to small businesses. most of it is 20 to 30% increases. the last couple of years. they're hopeful but they're not seeing it. unfortunately a lot of the cost gets pushed to the employee.
>> that's right. >> so many of the employees that were maybe picking up a couple hundred bucks a month and now paying 500 to $600 out of their pocket. if they don't get a subsidy, many of them are being gutted. so we like to talk up here a lot about the middle class, but a lot of this is putting the middle class at risk in terms of health care costs. and what's your thoughts on that? >> so i think this is why one of the things that we need to focus on now deeply is delivery system reform. that's the idea of better, smarter, healthier. by that, it's both about quality and i think we have to be careful when we talk about this topic because people hear it and we need to make sure we preserve quality and improve quality. why in our country do we have some of the lowest levels of quality offerings for health care? it's about improving quality and affordability. right now one of the things that we did in january, we committed the federal government, that
medicare payments 30% of them by 2016, 50% by 2018 will be based on value instead of volume as a part of working on this overall issue. because we want to hear what you're hearing and that's important to us. that's a part of why we think this is so important. let me close with the idea, because i have a few seconds. i hope we can focus more on affordability, all of us, because it's bankrupting a lot of people that don't get subsidies, and that's the reality in florida for small businesses and individuals. the focus needs to be on affordability and find a way to bend the curve on health care cost. thank you, madam chair. >> i look forward to the opportunity to actually work with you on these delivery reform issues. >> mr. smith? >> thank you, mr. chairman, and thank you madam secretary for being here today. limited time and a lot to cover here. as you know, as we spoke earlier about the consumer operated oriented plan programs which were the alternative to the public option. i would argue these are perhaps somewhat quasipublic options.
to date i believe hhs has award $2 billion in federal loans to establish the plans or one plan, as you know, co-opportunity, which served over 100,000 people in nebraska and iowa was seized by the state of iowa and has since been liquidated. folks on the plan have been left confused, frustrated and again looking for other plans. i sent a letter on january 23rd asking specific questions, did receive a response on may 21st. i would like to request unanimous consent to submit both of the letters for the record. thank you. now quickly some questions. it received $146 million in federal loans, and will any of the dollars be paid back to the federal government? >> with regard to that that's a question i will follow up on.
>> appreciate that. my understanding was iowa and nebraska were told they could not suspend enrollment in co-opportunity and have it remain a qualified health plan yet tennessee was later allowed to do so. do you know why that policy changed? >> per our conversation, i did follow up with cms. we didn't have the record of that request in any way coming in. i'd love for our team to be able to follow up and understand if there was miscommunication. based on your comment, it was something concerning to me when you mentioned it and i went and followed up. if we can work with your staff to understand what your staff understands happened, that would be helpful. >> recent reports claim only one co-op did not have an operating loss in 2014. is that accurate? >> i would have to go co-op by co-op. >> are there any concerns about
possible liquidation of any plans in the near future or not too distant -- >> with regard to the co-ops, they are new businesses and start-ups like the small businesses we were just talking about before, we're going to have failures in terms of the co-op system. that's part of the money that congress gave but then went to $1 billion. there will be co-ops that have challenges and issues. we're working closely with state insurance departments to make sure we get in front of them and do the kinds of things that we attempt to do in the co-opportunity situation. it was important that we engage in supporting communication, offering a special enrollment period and working with the state insurers to use our and any authorities we had to make sure that those consumers were taken care of. >> will any of the consumers that lost coverage from the failed co-op be penalized by the individual mandate? >> i do not know how many are not still in systems, but i will check and follow up on that. my understanding is no, but i can't to confirm that. >> in that vein i have introduced hr 954 who would exempt anyone who lost health insurance from the failed co-ops from the individual mandate. could the administration support that approach and that piece of
legislation? >> what i'd love to do is have the opportunity to see if that is something that has already happened or not and then review the bill. >> in the bigger picture of obviously large sums of money being offered to these consumer-operated oriented programs, what is the likelihood of those dollars being paid back? >> with regard to the loans that have gone out? i this with regard to a number of the co-ops, that will happen in terms of the successful co-ops and those that are gaining traction and working. as i said there are maybe some that are not. and we'll get back on that specific question. >> seems to me also that various states relevant to this issue might have a different approach for paying on the claims that were submitted by -- how on top of this are we? because it's -- in nebraska
there is a fall back and yet it hurts more people. i apologize. my time expired. >> state insurance law, as you know, is a big part of how that gets determined, but we try to work and support the states with different options. >> time for the gentleman has expired. mr. blumenauer. >> thank you, mr. chairman. madam secretary, i appreciate your reluctance to deal with hypothetical legislation that has not yet been written to deal with a legal decision that hasn't yet been rendered. i think that's prudent. but if this current takes place by the court, it would seem to me that it would not be rocket science, as some of my colleagues have mentioned, to make relatively minor changes to conform statutes to the intent and text of the bill and move forward. i think the committee could take one weekend and fix it and move on. i would like to shift gears slightly. we have had an ongoing series of
conversations. it's been six years since a provision i authored was approved unanimously by this committee. not just part, unanimously by this committee dealing with end of life care. that provision, despite a kerfuffle and certain rhetorical flourishes, remained in the legislation. unfortunately, it fell victim to the reconciliation process. and six years later we're still trying to achieve those objectives, although the world's moved on. best-selling book by bill frist,
billy graham all agree that this is necessary. you recently received a letter from 65 notable national organizations calling on you to have medical reimburse -- medicare reimbursement for advanced care planning. as you know, the ama did the coding. its all teed up, ready to go. we thought the administration was going to be there, and yet it lingers. published peer-reviewed research shows that advanced care planning leads to better care, better patient and family outcome, fewer unwanted hospitalizations. the list that you personally know is compelling for this service. is the administration prepared to finally move forward and authorize it? >> with regard to, as i think you just mentioned the ama has
given us the coding and we are in the process of reviewing that. and as we indicated in a recent rule making we indicated in our preamble, that's something we're working on reviewing the coding. >> it has been six years since congress embraced it, and this committee approved it unanimously. we have had the research clear -- the iom dying in america, i'm trying to understand what is it that is so hard to figure out whether or not this is part of the legacy of the obama administration which has done some good things with health care. this seems to be a really terrific thing that is really simple that would make a huge difference in people's lives. private insurance is moving. what it is that's hanging this up? why can't we just get to yes?
>> congressman, as we have said and in our conversations and our team's conversations with you, this is an issue we're going to continue to work on. because we want to make sure if we move we do make the progress that we would intend to make. >> i find it mystifying that the rest of the world is aligned. this is one of the few things that this committee agreed to unanimously. and that we see the difference it makes in human lives and the administration continues to study. i'd really hope that this could be part of the legacy and that it's part of the 2016 reimbursement. i find it frustrating beyond my ability to express. i'm happy to -- i've walked the plank for this administration on things before. and this is really troubling. >> thank you. time for the gentleman has expired. ms. jenkins. >> thank you, mr. chairman and thank you, madam secretary, for being here today. i want to echo the comments of chairman ryan and others on the committee regarding the supreme court decision later this month on if constitutionality of the
president's health care law. many kansans are poised to lose their subsidies which are the only thing that makes them affordable. my constituency is facing increases of 30% next year, which in addition to the loss of their subsidies will make their insurance unaffordable. i'm extremely frustrated because i had an exchange with your predecessor, secretary sebelius, three years ago on february 28th of 2012, when she was a witness here before the committee. and on that day i expressed my concern that i did not see anything in the present's health care law that would allow federal subsidies to flow through non-state based exchanges. and i told her the administration did not have the authority to allow the subsidies to flow through the federally facilitated exchanges even though the irs at the time was telling congress that the distinction didn't matter. because in the law there is no mention of the term "federally facilitated exchanges." but even though secretary sebelius promised me that hhs would give me a detailed answer in writing defending her interpretation of the law, she
never did. obviously this issue didn't go away, and now the supreme court will finally weigh in on it. i'm equally concerned when you suggest the decision before the supreme court is just about the subsidies because it isn't. we have research from the american action forum which talks about all of the positive outcomes from a decision by the supreme court against the administration. over 11 million individuals freed from the individual mandate? over 260,000 businesses freed from the employer mandate. thousands -- hundreds of thousands of new jobs. 1.2 million workers added to the labor force. but with limited time, what i'd like to do is turn my attention to a different topic. i've introduced legislation the past three years along with my colleague representative kind from wisconsin who repeal a provision in the health care law that allows folks to go to their doctor to get a note to purchase over-the-counter medicines with their ssas or sfas. this presents massive red tape that they need to purchase
over-the-counter medicines whose use saves the health care system money. additionally, it presents physicians with the bizarre scenario of unnecessarily seeing patients in order to prescribe over-the-counter pain relievers or allergy medicines. this provision makes care less affordable, more confusing, clogs doctor's offices and makes patients less likely to use over-the-counter medicine. so madam secretary, i was just wondering if you think that this is good policy and if you would support us in repealing this provision? >> so as i have articulated, one of the things we are focused on is this idea of how we can improve quality and move forwards affordability. this specific piece of legislation, i'm sorry, i'm not familiar with and not familiar in terms of the issue that i
think you're trying to resolve. so this is one that i would want to understand. i also do want to return to where you began. >> okay, but in theory, would you support this if we can convince the chairman to mark up the bill and move it over to the senate? because we've done that once. it's already passed with bipartisan support out of this committee and out of the house once before.
>> congresswoman, i would want to look at the substance of the issue before i could comment on that. it's not one i'm familiar with. >> all right. >> thank you so much. mr. paulson. >> thank you, mr. chairman and ms. secretary, thank you for being here. in the limited amount of time i want to address a couple things. maybe first i'll just talk absent about, in minnesota, unlike many states, we had a pretty low uninsured rate prior to the president's law kicking into effect. and we had a high risk pool for people that had pre-existing conditions. it was existing since 1976. it wasn't perfect but worked pretty well. then high risk pool was closed making way for the new exchange program set up. a lot of the headlines, and similar to what we heard from the colleagues and the concerns about premiums rising, the headlines over the last few week in minnesota in our papers showed the experience under the
new exchange under the president's health care law has been affecting their pocket books. so it got here. eight minnesota health care plans propose premium hikes from 11% to 74%. we've got another story here, blue cross and blue shield of minnesota which is the largest insurer in the individual market, which you mentioned earlier about having the marketplace work, they now propose average increases of 54%. so certainly this is a pocketbook issue for family, individuals, small businesses alike and that's why i really do hope, regardless of the court decision and how that goes, that we'll be able to work with the administration on addressing some of these affordability costs. because when you're talking about premiums, this goes to the heart of affordability as opposed to talking about, you know, per capita health care costs being lowered in medicare and other areas like that. just some commentary there where we hope this cooperation will be coming forward. because we need a whole host of issues if we're to solve some of the challenges rather than just digging in and protecting every provision of the loss as it is intact right now.
i'll just mention this. my interests with medical devices and medical technology which we talked about last week is very important in my state. america has been a leader in developing these technologies and cure. innovation that happens at a really rapid pace but often the regulatory process does not keep pace. i don't think it's acceptable that american-made technology is available to citizens in our kens and not available to our patients here at home. the number one concern that i hear now, patient groups from doctors, investors and new companies and manufacturers isn't the fda. the biggest hurdle they now face is cms and the lack of certainty surrounding coverage and coding and reimbursement. these decisions can take two or three years. and that's after the devices have already been approved. this creates a lot of uncertainty for doctors and manufacturers that want to use the best available technology for their patients. my question is what can hhs do to oversee cms, right, which is under your authority, to make sure that we're bringing certainty to the coverage, to the coding and the reimbursement process for medical technology
that can lead to less invasive procedures and a whole host of areas of health care needs and save money but it is definitely an impediment right now. >> on the issue of the dme and the cms we'd like to work -- we'd like to get that balance between making sure -- we've all talked a lot about growing health care costs. so making sure that the evidence-based decisions in terms of cms saying they'll pay for it. fda determines its safety, then cms determines if we'll pay, if the benefits are such that it should be part of a payment scheme. we'll continue to move things through quickly, but we'll try to figure out the ways that we balance it about if there are places and things that you have ideas about faster that's something we'd welcome in terms of what you're hearing from the companies. the other is the touch on the premium issue. it's part of a ac ashes's effort
to make sure that we have transparents ets and downward pressure on premiums. what's been in the news is any premium increase that's above 10% has to be reviewed by state insurers. so what you're seeing in the space right now in many of the articles, i'm not sure of all the headline that you read, but a number are about the fact that these are their first submission. last year we saw those come down because the review process works. because there are conversations like this in public that it creates downward pressure on those premium increases. so it is a part of the process and it doesn't reflect the whole base. most insurers are saying that the majority of their people that they think they'll enroll next year in 2016 will have premium increases less than 10. so we agree with you on the importance of that downward pressure. >> thank you. mr. kind. >> mr. chairman, madam secretary, thank you for being here. obviously there's a lot of
attention and focus on keen versus burrell and where that comes down. how quickly could this congress if it wanted to enact legislation language to fix that overnight the if it is an adverse decision from the supreme court? >> i think i wouldn't -- i'd be hesitate for me to say how quickly the congress can act. >> no, assuming there's a willingness. >> but i think the question of the issue if it is ruled that it is about the subsidy, that's a relatively simple solution that one can do legislatively with regard to subsidies or those in the federal marketplace. >> i come from a state, wisconsin, i'm very proud of, but i've never seen a greater act of physical malpractice by the current governor than what's been perpetrated the last few years in his denial of the medicaid expansion money. in his budget this year he's proposing over $300 million of cuts to our university system but if he took the medicaid expansion money over the next two years that would bring into the state $350 million over the next two years.
it just seems to be basic math. and his denial of that is not only denying people that are tough to cover to begin with but also get that money into the state where it can do some good in wisconsin. i know you, especially, and hhs have been working very closely with many other republican governors throughout the nation to figure out a path forward on waivers and modifications. i would encourage you to continue those lines of communication because we need help in wisconsin. he rejected the ability for us to form our own exchange. we're in that box right now looking at the supreme court. we could have done it the wisconsin way and created our own health insurance exchange. he chose not to. if we do get an adverse decision, 166,000 wisconsinites would lose their premiums and insurance would be rendered unaffordable to them, too. there's a lot riding on this decision. hopefully we'll be able to continue to work with the states and convince them to do the right thing, especially in wisconsin where we need help. i appreciate your sustained
focus not only on delivery system reform but payment reform, getting to a quality based reimbursement system. i agree with my colleague, mr. buchanan, that more needs to be paid to cost containment. there are some good news, but you set up the new network on quality collaboration and i hail from the land of integration, coordination, quality measurements, best practice, value-based medicine and that, but if your estimation how quickly can we pivot to a quality-based reimbursements system? >> when one considers that medicare dollars are a large portion, we believe that we can move to 50% by 2018. the goal for 2016 being 30% we set out because obviously i won't be here and so we need to set a goal and achievement. at the point at which 50% of medicare is based on value and what we're trying to do is make that passed by this network. i'm meeting with the insurance
ceos as well as ceos of companies because those are the other payers. in new york state, actually, medicaid has committed to do the same thing we are. so i think the path that we have medicare on is close to the trajectory for the nation in terms of moving towards more value. >> you mentioned new york. why do you think more states aren't taking up this challenge and converting medicaid to that type of payment system, too? >> i think that more states are interested, and in our conversations with states, i think a number of states are not wanting to have the public commitment. and so a number of states are a part of that network and across all states. i can look around and have talked to governors from a number of your states that are willing and thinking about this because they believe getting the value-based payments in medicaid, which is a large expense for the states, is a very important thing. there are states that are interested that are not at the point of public committal. >> thank you, mr. chairman.
>> we are now going to move to thee minutes a person. in order to try to fit in as many people as possible. mr. marchant. >> thank you, mr. chairman. secretary burwell, in the time that the affordable health care act was being adopted. for probably the most unpopular aspect of it and most debated in my district were the ipab panels. many names were given to those panels. i was able to cast a vote publicly that would abolish that panel. yet there's talk about strengthening the panel, there's talk about expanding the panel. could you give us an explanation of what this talk is all about and what the purpose of it is. >> with regard to the changes in
our budget around ipab, it is to strengthen and increase the medicare savings. because as we have all discussed health care costs and the issue of health care costs and medicare being a core element of that is a very important one. what we're hopeful and in the budget the $423 billion of medicare savings that is specific in specific ways that we can all have a discussion about -- i know there are those who disagree with us about the balance we have a provider and beneficiary approaches to getting that money, but i think what we believe is that ipab as a tool and a tool that the congress would still engage with because you all would approve
anything that was suggested by ipab, the congress would have the opportunity to give it a thumbs up or thumbs down is an important tool to keep the pressure on all of us. i think we all know medicare expenditure is a tough issue. it's a very tough issue for everyone in terms of even the issues we're talking about, about payments for dme or other things. that's what drives those costs upward. we believe it's a tool in the toolbox. but we're focusing on things that the congress could review. right now it wouldn't kick in -- in the president's plan it would be 2019. if you don't do those changes, it would be 2022. that's obviously another administration. >> why has the president not named anybody to the panel? >> with regard to the issue of panel members, it's something that we believe we should do in consultation with the congress. so that has been a place, and i think it's because of, as you were expressing, making sure if you are going to name a panel, that there is appropriate congressional input. and the other thing is, at this point, now that we see the numbers and we have made improvements in terms of the trust fund's viability increased by many years, the need is not
for now. and it would be in another administration. the question of us naming the panel now -- >> so the president will not name a panel in his administration? >> at this point with regard to where we are in the budget, we have not yet done it. >> time for the gentleman has expired. ms. black. >> thank you, mr. chairman and thank you for being here secretary burwell. we ask for consent to submit this report. >> without objection. >> the affordable care act requires the exchanges to determine if applicants were offered health insurance by their employer, and if they were offered that comprehensive and affordable konchts -- coverage, then those individuals are not eligible for the premium tax credits. the general inspector reported in this report stated that neither the federal nor the state exchanges were able to verify most individuals' attestation that they were not
offered health insurance by their employer. this is happening despite the fact that the burden and the costly reporting requirements have been placed upon our employers. what is it that hhs is doing to ensure that people who receive these credits are legally eligible for them? >> so much of our -- this is the aptc that you're referring to, correct? >> that's correct. >> with regard to that, we have a data matching process that we are doing, and it checks both immigration status as well as income status. and that's one of the processes we are doing to make sure that people who are eligible, and we release numbers i think you saw last week where over 100,000 people came off the rolls because we were not able to verify the information. so that is a process. it's a process last year that took a longer period of time. now we improved to a 90-day period of time. >> so let me quickly go to the other part of this which involves the irs. because in their application,
that is individuals' application for this coverage, individuals are asked if their employer offered them health n. and the exchanges then are required to provide the applicant's response to those questions along with the information related to the employer to the irs. in a monthly data report. this report, again, found that the treasury found that neither the cms nor many of the state exchanges were able to submit this information until well after 2015 filing season was complete. so it appears that two of those state exchanges still have not provided that required information. this is just one example of the numerous delays from cms when it comes to obama care. so healthcare.gov alone took over a billion dollars to build and yet it's parent that these systems is are still not fully functioning based on this report. so cms undertook this mammoth project without effectively planning for the development or the oversight. and this has led to hundreds of millions of dollars. these are taxpayer dollars that are being wasted. so my question is can you outline the oversight that's
being conducted to ensure that the legal requirements that were set up by the law are actually met and that systems are properly developed to protect our taxpayer dollars. >> i want to check because this report, as you probably know, have been over 50 audits of the affordable care act. i want to make sure that i'm focused on the right one. with regard to the one that you're speaking about, if it is the one i'm thinking about, we're now in a place where the information is going from the federal marketplace to the irs on a monthly basis. and you know, with all of these audits that we've received from both igs and the gao, we continue to work their their suggestions. i think that's that one. we'll follow up if that's not the case that we're now in a monthly reporting dv. >> i would appreciate following up. >> thank you. >> thank you, mr. chairman. thank you, madam secretary.
i'm pleased that during your confirmation process you expressed support for improving the safety of medical devices. a few of us have brought that up. by incorporating the fda's new unique device identifier. the udi. system into health insurance claims. myself and chairman brady talked about this in the past. i'm asking you today, despite this widespread support, that some in the cms -- i'm putting it mildly -- have resisted this important public health and patient safety effort. so we need the tools. could you commit to work with the committee this summer to move the policy forward? >> i do commit. and i think we have made some progress of fda and cms working together on something that will actually be more implementable. so we're working on it and be more implemental. we're working on it and it's
something that your comments and the chairman's comments and others are recognized when i came in, so we have been working on it, but we look forward to working with you further. >> let me shift the gear. you think that my colleagues on the other side cobbled together all of the time they tried to undermine the aca they would come up with an alternative to the law. they can't find anything good to say about, anything. so, and this committee alone we have had over a dozen hearings just on issues related to the individual and the employer mandates. many members in good faith i'm sure, brought this up today. not to mention, neurarly 64 votes to repeal or undermine the aca, make no mistake about it that's what this is about. and how many have we had on this elusive republican alternative i keep hearing about? zero. the reality is that this act is
working. it has problems. medicare has problems. medicaid has problems. this is a very imperfect world, madam secretary. more than 10 million americans have health coverage through the marketplaces. 85% received tax credits to help the cost of coverage. so while we're waiting, i'm interested in one question. as the aca impacted employer sponsored insurance offer and take-up rates and does the aca maintain the financial incentives for employers to cover and to offer coverage? that's my question. >> so this past week, we have seen a piece of work by the urban institute with regard to the number of employer based -- the scientists that we have certainly cbo changes to its numbers. most recent changes to its aca
numbers have to do with the fact they have now lowers the number of people they think will switch from the employer-based market to the marketplace. the urban institute numbers that came out this week say they're actually in percentage base, a very slight, i would call it basically the same. no decrease but the same. a slight tip-up but not numarically significant. actually maintenance of those in the employer based market so there's not been a decrease. >> thank you mr. young. >> madam secretary, thank you for being here today. the president, after the g-7 summit this week said the affordable care act is working. part of what's bizarre about this whole thing is we haven't had a lot of conversation about the horrors of obamacare because none of them come to pass. oblivious to some of the things i'm hearing in my own district saying, quote, it hasn't had an
adverse effect on people who already have health insurance. i'm frustrated. and i know many hoosiers are frustrated by the adverse effects they have experienced from diminished coverage options to lack of accessibility in their own communities for care. a lot of people are being squeezed when they go into the exchanges with a price increase on premiums. and then there are the penalties, of course the mandate taxes that exist if they can't afford to buy health insurance. and so i just want to humanize this a little bit for you. because i know you're quite conversant in the statistics and the goings on of much of this health care law. patsy from my district in jeffersonville, indiana, her premium went up $135 a month. she no longer has access to the family physician that has cared for her for over 25 years. brandon from greenville signed up for health care his family can't use because his family's
deductibles are too high. and they make just enough that they don't qualify for assistance. jason from georgetown, indiana, had to seriously consider paying the tax because he didn't meet the premiums on the exchange. debra from new albany's premium skyrocketed to $800 a month more than her mortgage payment. these are iluslustrative to our larger problems in every state across the country every congressional district. you know, using the president's own words, these horror stories haven't come to pass. they are coming to pass. they're in existence right now. i just want to know what you believe, madam secretary, i should tell my constituents who are trying to comply with this law. are they merely collateral damage? >> with regard to the examples and stories i think they are
important, and they're important to combine with the numbers in terms of what we know, 16.4 million people in our country are no longer uninsured and the stories, i hear those stories and respect those stories but having travels 22000 miles and having been out, i heard the story from the woman in texas who said you want to know how to treat ms? you get sick enough to go to the emergency room and they'll treat you. now she said i will know how. >> in the near term what do we do? what do we do for the hoosiers who don't qualify for a hardship exemption? >> we need to make sure, have they exhausted that remedy. >> i made sure they have. our office has. >> have worked through it. the other thing, in a number of issues there's an issue of coverage care and selecting the right plan. the plans on the marketplace are very varied. there are many in terms of the questions of deductibility and that sort of thing. >> thank you mr. chairman and
thank you, madam secretary, for being here. earlier on you said the administration is looking for fixes and improvements to the aca. i want to run by a couple that i think, it's disingenuous if you don't help make some of the fixes. one of them deals with seasonal employees. the definition between seasonal workers and seasonal employees. i'm not sure if you're aware with the conflict in those definitions and the difficulties it's causing people. and the other is the hospital readmission program. this program was aimed to reducing unnecessary hospital readmissions called the hospital readmission reduction program. the goal was really something i would support and probably many of my colleagues support. in fact, it's estimated nearly $18 billion per year is wasted on avoidable readmissions of patients. however, the implementation of this program has been problematic, especially for those hospitals serving low-income populations. evidence suggests that economic
disadvantage especially in places available for medicare and medicaid are much more likely to be readmitted within 30 days of discharge regardless of physicians efforts to educate them. do you believe the criteria can be improved by adding clear adjustments for dual eligible status as well as other plan admissions such as those follows trauma? >> involve i agree with you. we have a proposal and a suggest of how to make some of the changes. the remarks we received back, important issue, not the right way to go about it. the congress has given us money to do a specific study to see how to correct it. we had a proproposal that others didn't. we believe it's an important issue. i want to understand how to account for that and do what your beginning point was, which is we know we have more
readmissions in terms of quality and price. we have tried to propose it. we didn't get it there. >> i have insuring beneficial equity in the hospital readmission program, a bill i have introduced which does have bipartisan support that i would hope the administration will consider and support. also, on seasonal employees, i have stars act hr-863 to clarify the conflicting definitions between seasonal workers and seasonal employees which is causing compliance problems for employers and individuals, interactions between seizeinality, the employer mandate and the employer mandate create opportunities for accidental noncompliance. that's another issue i would hope that we could work on because these are issues clarifying and fixing, as you said fixing or improving the current law. i thank you, and i yield back. >> i understand that the
secretary has a hard stop. i regret the fact that not every member will be able to ask questions of the witness at this moment. i would like to invite any member, particularly those who did not have the opportunity to give us the committee the questions in writing. we will submit them to the secretary, to the witness, and i ask the secretary to respond in a very timely manner to these questions from the remaining members. with that -- >> i would be happy to. i think a number of you have my cell number, so -- >> with that honor your deadline, the hearing stands adjourned.
on friday, the house considered trade legislation passed last month by the senate that would grant president obama the authority to negotiate international trade deals and give congress an up or down vote but no opportunity for amendments. the house voted on three different bills friday, including one on trait adjustment assistance which would provide job training to those impacted by foreign trade. that measure failed eded while the other two passed leaving john baen boehner to request another vote next week. we talk to a capitol hill reporter. >> adam behsudi joins us.
he reports on the trade deals that are happening and the bills and legislation on capitol hill. adam, we just saw on the house a lot of action on the trade deals, the taa the adjustment assistance not passing in the house, but the tpa passing. what happened here? >> right. so basically there was a rule formed for all of the trade bills, that house republican leadership put together and the rule was that in order to proceed to the fast track of the trade promotion authority bill and a third customs bill they would have to first vote on a trade adjustment assistance renewal bill. that basically, that program gives job training benefits to workers who are displaced out of their jobs as a result of trade deals. so that vote failed. and then as a result the other
two votes, they were voted on sort of in a symbolic vote but the votes did not actually pass those bills. >> and now, do you know anything about the behind the scenes the back and forth and why they decided to take up that bill again? >> well, right. so basically, this morning, the president came to the capital, met with the democratic caucus urged his democratic, fellow democrats to vote for taa you know not to spite tpa. he said you support this program in the past. you'll support it in the future. so you shouldn't just vote taa down to defeat tpa but that seems to have fallen on deaf ears and what you saw was the democrats really disregarding what the president had asked them to do and voted against taa basically to block tpa. so basically, the path forward
now is they're going to come back next week and probably early next week in the next -- probably in the first two or three days of next week they'll vote on taa again under the same rule. so that will basically bring up they'll be able to use the votes on tpa, which passed, and then they'll be able to use the vote on customs, the customs and the authorization pass, which also passed. they can kind of preserve those victories, but they'll have to bring back taa. and the challenge there is, how are you going to get so many democrats to reverse their votes? and i think there's a lot of skepticism that that's going to work. earlier today the kind of the faction of pro-trade democrats led said there's still a lot of room in our caucus and in the republican caucus to get that taa vote passed.
but i think no one is under any illusion it's going to be pretty difficult to even if they bring the vote back up to pass it. >> and you mentioned the customs enforcement bill. that passed 240-190. it goes on to the senate now. why? >> there are a number of amendments in the customs bill basically, the whole plan originally was to not have to conference the tpa bill. they want to get that to the president's desk as soon as possible because they're basically trying to wrap up this transpacific partnership deal where that would be necessary that trade promotion authority would be necessary to get it through congress. basically, they mondayamended the tpa bill that came out of the senate on a few points here in the house, but basically with all those amendments were put in onto the customs bill to
basically preserve that bill from having to go through a second procedureual step. >> at the end of all this, too, this is essentially a fail for the president. he's been really lobbying for all of this this trade package. what does that say about his power and also the minority leader's role, nancy pelosi? >> i think the minority leader has been you know today was actually the first day you heard her say her position on these bills. she's withheld any sort of judgment on these bills, at least publicly. she hasn't said which way she would vote for them. and she's facilitated conversations between the white house and the cabinet and members of congress. she always called it getting to a path to yes. but you saw that, you know, she ultimately sided with the majority of her party on this
and voted against it. but the president and his cabinet have been lobbying these bills for a long time. they've been sending cabinet members up to the hill for meetings. you know, the president himself has engaged directly with members via phone calls. and other ways even, you know taking people on trips. he took a number of members the g-7 in germany a couple days ago. people that have had declared their support but all that as you saw, you know it didn't result in the result that he wanted obviously. >> thanks for the round-up on all of this adam. we'll keepowing you. abehsudi, and we'll look for your writing in politico.com. >> thank you. the new congressional directory is a handy guide to
the 114th congress. with color photos of every senator and house member. plus bio and contact information. and twitter handles. also, district maps a fold-out map of capitol hill, and a look at congressional committees, the president's cabinet federal agencies and state governors. order your copy today. it's $13.95 plus shipping and handling through the c-span online store at c-span.org. here are some of our featured programs this weekend on the c-span networks. on book tv on c-span2 saturday night at 10:00 p.m. eastern fox news contributor kirsten powers says although they were once champions, liberals are now against tolerance and free speech. on sunday night at 11:00 former deputy director of the cia michael morel on the successes and failures of the agency's war on terror and its current fight against al qaeda and isis and
on american history tv on c-span3 saturday night at 9:15 kevin mcmahon on the strategy on nixon's supreme court appointment, and sunday night at 6:00 on american artificates, we visit the national museum of natural history to view the newly restored murals. and the founding of talladega college. get our complete schedule at c-span.org. texas governor greg abbott recently gave the commencement address at the university of north texas in denton. he talked about the importance of responding to life's challenges while discussing his own experience of becoming partially paralyzed at age 26. he was elected in november. this is 15 minutes.
thank you, all and thank you, president. the university of north texas is fortunate to have you at the helm of this remarkable university. as you begin the next 125 years for the university of north texas. i'm deeply honored to get to participate in this celebration for this commencement of the north texas mean green. now, i know first-hand the caliber of the students who attend the university of north texas. my nephew, ryan abbott graduated from north texas five
years ago. in 2010, with a degree in emergency administration and planning. he now works with the philadelphia office of emergency management. and the university of north texas would be proud of him today because of what he did earlier this week, when he put his degree to good use helping to respond to the tragic amtrak crash that took place just outside of philadelphia. now, i also got to know recently another current unt student. his name is nick bradley. now, for nick, after he graduated from high school, he didn't come straight to unt. instead, he enrolled and joined into the united states air force. he served in the united states air force until 2008 when the truck he was riding in blew up
because of a bomb in afghanistan. after 16 surgeries months of rehabilitation, and raw determination, nick pieced his life back together and is now going to be a senior right here at unt. i was with nick last month at the opening game for the texas rangers baseball team. with 52 screws holding his arm together, nick threw out the first pitch of the game, and it went right over home plate. well it's because of nick and
because of everyone like him who has fought on battlefields across the globe that we have the freedom to fight on the battleground of ideas in places like the university of north texas. and we never say thank you enough to the men and women who provided that freedom to us. and i want to take just one moment and ask anybody in this arena tonight who has ever worn the uniform of the united states military to please stand or wave your hands so we can say thank you for your service.
>> well, to the class of 2015, congratulations on reaching this remarkable milestone in your lives. your hard work, your dedication your drive brought you to this moment. you know, i think very fittingly, moments ago, you applauded your family and friends who helped bring you to this day. i want you to think about this. there's one thing we know for sure. and that is that these family members of yours are extremely proud tonight. you cannot imagine the sense of joy they feel right now. so tonight would be a great time to ask for money.
now, in addition to the pride that you surely are feeling tonight, some of you may also feel a sense of sadness, a sense of sorrow, thinking that your days at unt are behind you and that your unt days are gone forever. well, let me assure you that you never really leave because i can guarantee you that the unt fund-raising committee will be on your back until the day you die. i'm going to keep my remarks short tonight because i learned the hard way about going on too long. before i was governor and attorney general, i was a judge, and one time i was speaking as a
judge to a large room of people, and i was the next speaker and i came up in the back of the room and pulled up alongside a lawyer and asked him how things were going. he said, things are going pretty good so far but our next speaker is one of our long winded judges and you know how that goes. i said well do you have any idea who i am? he said, no i have no idea. i said, well i'm judge greg abbott. and i'm the next speaker. you could tell he was embarrassed, but he was a quick-witted lawyer. he looked back at me and said, well, do you know who i am? i said no, i have no idea. he said, great. i'm out of here. i know you want to be out of here and go start partying. so let me say just a few words. and i'll start out with some
candor. my last graduation was when i graduated from law school. i don't have a clue who spoke at my graduation ceremony. i seem to recall some cliche advice about how the future was going to be filled with challenges. little did i know how prophetic that speaker was because little did i know that as i walked across the stage that day to get my diploma, that picture would literally be the last picture of me walking. after graduating, i moved to houston, texas where i took a job. and after a few weeks of living there, one day i went out for a jog, and while i was out jogging, a huge tree crashed down onto my back. fracturing my vertebrae in my spinal cord, leaving me forever
paralyzed. and unable to ever walk again. i see some of you shaking your heads. you're wondering, how slow is that guy jogging to get hit by a falling tree? well, during months of rehabilitation, i realized that the future i had meticulously planned during college and law school, all the dreams i had aspired to and worked for and took for granted were gone in an instant. everything had changed. but i found after that in going on and piecing my life back together and becoming a lawyer and becoming a judge and attorney general and now a governor, i realize our lives don't have to be defined by our
circumstances. instead, we can define our lives by the character that we have. i learned that deep within each of us lies the character that allows us to conquer our circumstances. you know, i have never talked to any graduate from any program anywhere who had not faced challenges on the pathway to getting their diploma. i know that each of you have been challenged in different ways yourselves. all of you have demonstrated the character to meet those challenges. your presence here tonight those green caps and gowns you're wearing right now the
diploma you're receiving, show you have mastered your challenges. well, tonight, when you leave this wonderful school and go into the world to pursue your dreams, your lives are going to be filled with a lot of exciting twists and turns. you will have many more achievements in your lives. and yes, inevitably you will face some challenges in your lives. but those challenges don't determine your destiny. you do. your lives aren't defined by how you're challenged but how you respond to the challenges you face.
so wherever your paths may lead, whatever you may do after leaving here you know what. in the end it really doesn't matter. whether or not you turn out rich or poor. it doesn't matter what you do for a living or where you live. in fact it doesn't even matter whether or not you will be able to walk. what does matter is the unique fingerprint that you leave on this world. now, quite literally, your fingerprint is on every single thing you touch. you may be holding something in your hand right now that has the imprint of your fingerprint on it, but i'm talking more figuratively about the figurative fingerprints you leave behind whether they be on the person sitting next to you,
your classmates, your friends, your family or it could be a passing acquaintance. every single perp you come into contact with has your fingerprints on them. and ultimately your life will be measured by those fingerprints you leave behind. so as you leave the university of north texas we look forward to watching the path you take and the unique fingerprint you leave on this world. so congratulations to the class of 2015. may god bless you all with bright futures. may god bless the university of north texas and this great state. thank you so much. [ applause ]
>> democratic representative eric swalwell was recently in his congressional district to deliver this year's commencement address at las positas college in livermore california. he spoke to graduates for about 15 minutes. good morning las positas. thank you, doctor russell, thank you chancellor jackson. thank you board president gelis, board members, thank you to the
faculty faculty. thank you to the administration here, and thank you to the maintenance workers. the people who clean the classrooms before you got there in the morning the people who will take down these chairs when we leave today. this is a community college and it took a community effort to educate our youth and our future. and thank you to the parents and the families who look just as surprised as my parents looked when i was the first in my family to graduate from college. now, i don't know if you knew this, but today's graduation is being broadcast on c-span. now, normally c-span is the channel of congress. and i have to watch c-span all the time. and i can tell you that you guys look a lot better, sound a lot
smarter, and have a lot more hair than the people i normally have to watch on c-span. [ applause ] for many of you, your path to this stage was certainly not a straight line. i draw inspiration from a rabbi from the 19th century, of ukraine, who described his troubles and the challenges we face through the human condition as the world's, the whole world is a very narrow bridge. but the most important part is to have no fear. there are many of you who had no fear in your path to this stage. i think about sierra solis who
is the president of the poetry club. she served as the interclub council secretary stepped into the role of the aslpc director of events when it was vacated and all the while earning a 4.0 gpa and working with autistic children and families to support her own family. i think about katie lott your valedictorian and the narrow bridge she had to walk without any fear. she didn't just work hard to become the valedictorian. she also just recently won a national speech competition. and she did that struggling with and overcoming tourette's syndrome. she described her narrow bridge
as, when i'm in an environment where i have to be very focused like forensics, it's easier for me to suppress the tic, and it kind of goes on the back burner. once i'm up there in front of an audience, i go into speaking mode. i feel like i try not to use tourette's syndrome as an excuse. so yeah, my tics are something that i do all the time and it's natural to me, but it's not going to ruin my life. it's how i look at things and it's probably helped in a positive way. when i think about the narrow bridges that you've had to walk, i think about our veterans who are graduating today. who have made it so far. from the battlefield ss, from across oceans, and now going off into the community taking the skills that they have acquired to help others. this narrow bridge is a journey i know myself.
and my path to the stage certainly was never a straight line. i grew up in this area, the oldest of four boys. my mom, she still works today as a secretary. my dad is a retired police officer, and their dream for me was to be like many of you, the first in the family to graduate college. and we saw very early on the surest, the fastest way i was going to get to college, because we didn't have many resources to pay for it, was going to be through a soccer scholarship. and i made better and better teams. and i got more and more expensive. at one point, my parents thought i wasn't going to be able to pay competitively because the travel costs were just too much. but i pushed back. i later became a lawyer in life, but i started my first negotiation as a teenager. i said, what if i helped out and pitched in? and we all took side jobs and tried to pay for my soccer? and my brother's soccer?
they thought i was crazy, just like any parent would. but on the weekends, it was a family affair. every single one of us, from oldest to youngest, my mom and my dad we all refereed soccer in between our family games. during baseball season, we were umpire umpires. i worked at aeropostale folding clothes as a teenager. i was just as bad folding clothes there as i was folding clothes at home and that job didn't last too long. i sanded window frames after school and before soccer practice. i was a wedding entertainer's assistant. and i did all of this because i knew if i pitched in if i helped out, it would reduce my cost of soccer and i could achieve the family dream of being the first to go to college, and i did. i was able to play division i soccer back on the east coast. my parents were proud. [ applause ] and like every young athlete i thought i was invincible and i
would play professionally, and like what happens to mouth athletes, i got injured. but i had a teacher from high school who looked out for me. and he called me and said eric, i know you had your heart set on playing professional soccer. but i saw in your as a student someone who could also work and help others. something i had never thought about. i only thought about myself and my own athletic pursuits. he said, why don't you go to capitol hill and work as an intern? so i applied on a lark. i was hired, and i called home and i told my parents mom dad, i got that internship on capitol hill i applied for. they said to me what every one of your parents would say to your son or daughters. that's great. how much does it pay? i called the teacher back. i think we're good. i think it's all lined up. my parents want to know, are we talking $8 an hour, $10 an hour?
how much does this pay? he said, eric, it's an intern internship. you're going to work 40 hours a week, and if you work hard enough, you'll get a good letter of recommendation if you ever want to go to law school. so my parents told me son you're going to have to do the same thing we did when we didn't think we could pay for soccer. you're going to have to work. and so from 5:30 to 8:30 in the morning before i took that unpaid internship, i handed out gym towels at a local gym right around the corner from the capital. oftentimes members of congress would come in and i would check them out and show them around. from 8:30 to 5:30, i worked on capitol hill, giving tours answering the phones, responding to constituent mail, and starting to fall in love with the idea of helping people in need. but that didn't pay anything. at 5:30, i went one more block down capitol hill and i put on a restaurant server's outfit and i
served mexican food at a little mexican restaurant. and members of congress would come in and i learned very early that if i learned their name, i got good tips. i know it's shocking to hear that it's so easy to flatter a member of congress. that was my narrow bridge. handing out gym towels in the morning, serving members of congress in the evening, and having no idea that 13 years later, i would serve with many of them in the halls of congress. but what i had was a family who cared about me and risked it all, a teacher who looked after me, and a will to never have any fears as i walked across that very narrow bridge. and i know each and every one of you in your own journeys has fearlessly put yourselves up here today. so now you're moving on.
some of you going to four-year universities. others going off ina different trade and different jobs. and for so long we asked young people, what do you want to do when you grow up? what do you want to be? but today, the certainty of the market, the jobs that are out there, are so different and they're changing all the time. over half the jobs that will be around in ten years don't even have names. and so i'm asking you right now not what do you want to be. what problem do you want to solve? and i actually want you to tell me right now. we passed out these cards. and you can tweet and take out your phones on the hashtag hashtag #solveaproblem. right here as you're getting your degree and moving on, tell us what problem you think needs to be solved.
mark it down. we'll look back and see if it was addressed. #solveaproblem. maybe you're going to solve a local problem like fixing our drought. we can't make it rain. but as californians, all we've ever known is how to innovate. maybe you'll be the next engineer who will work on desalination or water recycling projects to make sure that california can continue to thrive. maybe you'll think more nationally. and solve a problem like access to education. our generation has $1.3 trillion in student loan debt for 40 million young people. and it affects every major decision we have to make. it's a problem that needs to be solved. from the decision to start a family to buying a home to taking the job you really want our student loan debt is a
generation weighs down on us like an anchor. and we must address this and make sure that anyone who is qualified has access to an education. maybe you'll solve a business problem. i think about the sharing economy and new companies like uber and lyft. or two people in san francisco who were room mates and couldn't afford to live in an expensive city and they were struggling to get by. when they realized they could host travelers in their apartment as a reasonable rate. they created a company that became one that is now the face of the sharing economy, airbnb. they thought creatively about how to solve a problem, their own problem, and then created a website to give others a way to do the same thing. tonight, one million people will sleep underneath the roof of an airbnb. there are so many problems that
we need you as a generation to solve. so again i challenge you, tell us tell me what problems you'll solve. i see natalie padilla said getting more help for people who have cancer. jalen, who is in the audience, a graduate, says climate change. these problems you have been given all the tools from las positas college to solve. and i hope as you go along your path, as you continue to find mentors and teachers that you'll remember that you have two hands. one to continue to reach up and receive more skills to solve the problems around us. but don't forget that the other hand should be used to reach down and to lift others up. next year five years, ten years from now, hundreds of graduates
will sit in those very seats, and it's my wish for you that you take all of the skills you have acquired and remember that they will be better and more enriched if you reach down and lifted them up like you were lifted up by your mentors and your teachers. las positas college, john f. kennedy said and it was his birthday this week that the american by nature is optimistic. experimental, and a builder. who builds best when called to build greatly. today, you were called. you were called to solve some of the greatest problems of our time. remember how you got there how you walked across that narrow bridge. answer the call and reach down and pass your knowledge on to others. thank you so much. congratulations, las positas.
preet bharara is the u.s. attorney for the southern district of new york. he gave the commencement marks to graduates of uc berkeley law school. he's known for his prosecution of white collar crime on wall street. in 2012, he was named by "time" magazine as one of the 100 most influential people in the world. his speech is 20 minutes. dean childry, distinguished faculty, proud parents family, friends, and graduates, congratulations to the class of 2015. you have so much to be proud of and so much to be grateful for. congratulations to all of you.
i want to congratulate the student speakers and also professor brought who i will tell you on the record stole a lot of my material. i was totally going to make the joke. thanks. i learned -- i always learn something when i come to law school, even when i'm not an attendee of the law school. i graduated from columbia law school 22 years ago, and it was newed to me that in all that time, it turns out there is still a legal writing requirement. i thought we had gotten rid of that. i was a little bit nervous i will tell you, when i came here to speak this morning. i have given commencement addresses before, but never in california, never in northern california, and i had some butterflies. i was worried would you understand my new york accent i don't know if it's going all right so far. so i arrived, and this is different for me. usually i'm in a different kind
of venue not in an unbelievable greek theater. then i heard the steel drum band, and that calmed me down completely. i just want to make one basic point this morning. and it echoed what has been said already. it's this. you are joining a profession much maligned and often misunderstood, that presents virtually infinite possibilities, infinite possibilities to grow, to learn to achieve. but not only that. the law also presents infinite possibilities to do good, to help other people, to serve. there are so many ways as a lawyer, not just to make a living, but to make a difference. on a day like this, the air is inevitably thick with expectations. expectation of what kind of mark you graduates will make on the world, but if we're being
honest, there is also inevitably some trepidation also. and not just when you think about how you're going to pay back your student loans. you may be asking yourself, did i make the right choice? is this the right career? what if i'm not good in the courtroom. what if i don't like billing in six-minute increments? these are all natural worries. so let me start by offering a mildly radical suggestion. promise yourself today that if you are not happy in your first law job, after giving it a genuine chance with genuine effort and a genuinely open mind, move on. quit. and do that for every job you ever hold. if you don't like your job, because of the people or the politics or the hours or the work, you can leave. you have worked too hard and invested too much to accept a
long sentence in a job that you hate. i have seen in my years in practice too many people unhappy in a law job because they stayed too long, because they let inursha overwhelm their free will. now, i'm generally not an advocate for being a quitter, but i am an advocate for being happy in your job. i believe you should grow and mature and learn and derive joy actual joy, from your work as a lawyer. and one reason i can so blithely suggest you quit if you don't like your job, because i think it gives you more mobility than just about any professional degree you can get. if it turns out you don't like the first congressional path you wander down, you can double back and take the path less traveled by. if you go to a law firm and don't like it, you can go in-house. if you don't like private
practice, you could do public service. i could encourage that. you should do what makes you happy. you should do what brings you joy. in fact, here's a news flash. ultimately, you don't even have to practice law at all. if you don't like it. i know at this point, there are some parents saying what the hell is preet talking about? does he know that this is a law school graduation? maybe the steel drum band had an effect on him. we just paid $160,000 for this education. what do you mean, don't practice law? now, before you start throwing things at me i should let you know this happened in my own family, not with me. my parents went through it with my brother vinny. yes, somehow i have an italian brother. diverse family. so my brother was a trained lawyer, but after time he was
bitten by the business bug. he felt a pull towards becoming an entrepreneur so he left the law. his first dotcom business didn't do so well, but he recovered. in 2005, he started another e-commerce venture with his best friend from high school, this time, selling of all things diapers. so basically my brother, remember, this is a proud indian american family my brother went from being a scholar at columbia law school to selling diapers on the internet under the slogan and this is true "we're number one in number two." i have the t-shirt. it's true. you laugh.
my brother laughed too. especially on the day that he sold his diaper company to amazon for $540 million. [ applause ] yes, my brother is now what plaintiff's lawyers call a deep pocket. my brother, by the way, is a fairly competitive guy, vinny. this is also his way of saying hey, bro i see your whole u.s. attorney thing. and i raise you $540 million. so here's the thing. this is also true. my brother would be the first to tell you that he owes a large part of his success to his legal training and his time in law practice. he doesn't regret that at all. it sharpened his mind taught him rigor and enforced his work
ethic. you can do anything you want with your law degree. you can be a grade school teacher, a community organizer, a tv producer a sitcom writer, a novelist, and some of those may sound far fetched but i have law school graduate friends who have done each of those things and even in this group, who left the profession all together, each credit law school and lawyering with a good chunk of their success. but not withstanding all the choices you will have, i federal reservantly hope you will keep faith with the law that you will keep on a legal path, and why do i say that? because there are so many people yet to serve. there are so many causes yet to champion. there is so much justice yet to achieve. who better to achieve it than you? and why do i say that? because the power of your degree gives you a degree of power that few possess, fewer know how to
use, and still fewer know how to put to good purpose. you will have opportunities to improve your community and country that others can only dream of. and that is something to behold. especially at this moment of just starting out, at this moment of commencement. so here's an observation since i'm in northern california. with silicon valley just a stone's throw away this university is one of the top feeders to that tech and start-up mecca. i'm told by the dean up to 25% of you may go work and counsel the great bay area entrepreneurs of our time, following in the footsteps of one of your alums larry sin seeny. it does occur to me that each of you is in some ways like an individual mini start-up. you have yet to turn a penny of profit. but you really really swear you will have income soon. you don't even have a business license yet, but you claim to have a plan.
you haven't provided any substantial good or service, but you are said to have much promise. and like any start-up worth its salt you're celebrating with an over the top public launch. in this case a gigantic outdoor greek theater. but perhaps most importantly, you are surrounded by deeply supportive investors who believe in you and will trumpet to everyone they know that you will succeed. [ applause ] if i could pause on the silly analogy just for another second. there are reasons for america's enchantment with the tech and start-up culture, and it does not, i think, have to do only with the gargantuan profit potential, though there is much
of that. ceg, vinny. i think it has to do also with the spirit of unbridled optimism and daring, the spirit of energy and passion. it has to do i think, also with the faith and possibility and attraction to the pioneering spirit. never mind most new ventures fail. each silicon valley success story can be seen as another example of the enduring notion of the american dream. and that is something very special. but often i wish we had more of that optimistic and visionary spirit in our own legal community and in our own legal and government institutions. because the law needs risk takers too. the law needs entrepreneurs, too. the law needs dreamers too. and no matter what you decide to do in the law, i hope you find a way to inject some of that spirit, because an idealistic
lawyer can not only achieve the american dream but open up that dream to other people also to the disenfranchised to the downtrodden, to the discriminated against. it's certainly impressive when someone figures out how to deliver advanced technology to your wrist but what about when someone figures out how to deliver justice to your life? a driverless car? well, that seems downright magical, but don't ever underestimate the promise of your own profession the noble profession you embark upon today, because the law practiced with hope and idealism can lift people up, too. it can inspire wonder, too. the law, if wielded well, can work a type of magic too. you think the iphone is elegant? you think a tesla is beautiful? iphone sell ganttis elegant?
you think a tesla is beautiful? what about something that's beautiful is inherently unequal? what about the argument that seeks to give every american the right to marry anyone he or she loves. [ applause ] >> what is more elegant and beautiful than that? your commencement speakers last year were david buoys and ted olson. they and so others that have brought equality have done so much for the modern era than any other tech pioneer spawned by silicon valley. [ applause ] >> and so the law has always had pioneers, too. but we need more. more pioneers for justice
pioneers for equality pioneers for fairness and i hope you find ways to add yourselves to their ranks. and to do that you must from time to time, take heed of some of those watch words of silicon valley. embrace risk think different think big. and there is no one in a better position than you to make a difference. there is no one better situated to preserve liberty, promote equality and prevent cruelty than the person who is genuinely dedicated to becoming both a master and a servant of the law. and sometimes all it takes is one person. i believe that to be true. one person, one lawyer armed with courage and a well-drafted complaint can bring a misbehaving industry to its knees. one lawyer armed with a searching mind and an obsession for truth can right a wrong. one lawyer armed with an idea and a vision for justice, can plant the seeds for a
long-lasting movement for reform. and one lawyer, motivated by conscience, guided by principle, and empowered by training can set an example for a generation of future lawyers. the thing to remember always is this:. this colon: the law can have great assist, but it needs help from human lawyers who are willing to help. the law is not self-actualizing. google may be developing a driverless car, but there will never be and can never be a lawyerless legal system. and that is as it should be. you know a business plan is in the execution. a joke is in the telling. a sheet of music is in the playing. and so it is with a system of laws. now, there is probably some cynics somewhere who may think that when i suggested a moment ago that even one person can make a difference, that's just overblown rhetoric.
that's just commencement cliche. i assure you it is not. it's the truth and it happens all the time in ways big and small, and so i want to end with a short story, and it's a true story. it's about a woman named kathy watkins. kathy watkins was arrested on february 16, 1995 for the murder of a livery cab driver in the bronx, new york. she was convicted by the local district attorney's office along with several others. she got 25 years to life. but here's the thing. kathy watkins hadn't committed the crime. kathy watkins was innocent. she had always proclaimed her innocence, but no one had ever believed her. no one believed her, that is, until in 2012 an investigator in my office, former nypd police officer john o'malley, happened
to come across evidence that cast doubt on her conviction. he was one person, and what a difference he made. there is no radio serial or hbo special about john o'malley and about that case, but he quickly took on the task of reinvestigating the murder. he didn't have to. it wasn't his case. and he had a thousand things on his plate already. but he studied the facts he read the trial transcript, and he interviewed new witnesses. and on the strength of that reinvestigation, backed up by prosecutors from my office kathy watkins was released from prison in 2012, and her conviction formally vacated by a judge. 17 years later -- 17 years later -- she was finally free. and so one person can make a difference, but there is even another lesson to this story.
the power of hope and possibility. you see kathy watkins even though she did not belong there had chosen to rise rather than to rot in prison. she had taken classes as an inmate through merrimount manhattan college, but she could only take three per semester, so it took her 11 years to get her bachelor's degree in sociology. but she got it. she had done so well that she was named class speaker at the ripe old age of 41. and in 2009 before all these events transpired she attended her own graduation ceremony behind prison walls, addressing fellow graduates who all wore prison garb under their gowns. and would you believe it if i told you that this wrongly convicted woman this wrongly imprisoned woman, after 14 years of seeing every plea of
innocence fall on deaf ears, after fully three years before she had any hope of release that she delivered that day a message of optimism and possibility and hope. you know what she said? she said even though these walls can restrict our physical movement, they cannot restrict our imagination nor our connection to the outside world. you know what else she said? she said one person can make a difference. let that difference start with you. three years later a stranger named john o'malley proved her right. so i say to the class of 2015, don't let anyone ever tell you you can't dream that you can't hope, that you can't change the world. don't take it from me take it
from kathy watkins. one person can make a difference. let that difference start with you. thanks and congratulations. [ applause ] on the next "washington journal," retired lieutenant general james dubik former transition commander in iraq, discuss president obama's decision this week to send 450 more troops to that country. and lawrence yun of the national association of realtors talks about the state of the u.s. housing market. as always, we'll take your calls and you can join the conversation on facebook and twitter. "washington journal" live at
7:00 p.m. eastern on c-span. on c-span's road to the white house, more presidential hopefuls announce their candidacy for president. live saturday on c-span. former secretary of state hillary clinton will kick off her campaign with a speech that will outline her agenda as a candidate, live from the fdr for freedom's park at 11:00 a.m. eastern. on monday at 3:00, jeb bush will formally announce his candidacy. and donald trump announces whether he'll make a bid for t at trump towers. you can watch any of these on line at cspan.org. c-span's road to the white house 2016. the senate homeland security and government affairs committee heard testimony this week from
good morning, everybody. i want to welcome my witnesses, say how much i appreciate your thoughtful testimony. i've read it all. there's some pretty compelling stories. this is, from my standpoint a very important hearing. as i look back at the laws written designed to protect people who have the courage to come forward within government to below the whistle, to tell the truth, to highlight problems of waste and abuse and corruption potential criminal activities within the department of agencies, we have a number of laws. and they date back quite a few years, and with mr. divine's testimony, i added some new. i didn't realize it went back to the year 1912 followed bit civil reform act of 1978 and the whistle blower protection act of 1989 and the whistle blower act of 2012. and yet we